| NPI | 1548618028 |
|---|---|
| Former Name | KERI DETWEILER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WV 3915) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 14171) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2022-07-26 |