| NPI | 1386096360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX V2511) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 7855) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2025-01-05 |