| NPI | 1518223122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD61063157) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: WA MD61063157) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-11-03 |