| NPI | 1609302769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MB11955400) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 12730724-8904) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-11-13 |