| NPI | 1578823555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 307194) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 17318) |
| 208C00000X Colon & Rectal Surgery (Licence: NY 307194) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2020-09-23 |