| NPI | 1518194083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME121158) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN18200) |
| 208600000X Surgery (Licence: PA MT197944) | |
| 208600000X Surgery (Licence: FL ME121158) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2016-09-19 |