| NPI | 1407347677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61667218) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: WA MD61667218) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2025-08-06 |