| NPI | 1487996807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 35.142762) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2020020217) |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2021-07-28 |