| NPI | 1619139839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IA MD-40041) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-8453) |
| 208600000X Surgery (Licence: IA 40041) | |
| 208600000X Surgery (Licence: OH 35.129078) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2022-07-21 |