| NPI | 1558990507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD.MD.61687077) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD.MD.61687077) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-07-16 |