| NPI | 1619964665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 38138) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MO 2008000432) |
| 208D00000X General Practice (Licence: MN 38138) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-12 |