| NPI | 1386177152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A159947) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: CA A159947) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-09-03 |