| NPI | 1477649929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M5623) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NY 238748) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-02-05 |