| NPI | 1578908588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60976566) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 59885) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD60976566) | |
| 208C00000X Colon & Rectal Surgery (Licence: WA MD60976566) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2020-11-30 |