| NPI | 1568857142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA A168789) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.027085) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2021-12-03 |