| NPI | 1528563418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 101116) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 29152) |
| 208C00000X Colon & Rectal Surgery (Licence: GA 101116) | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2025-03-27 |