| NPI | 1639326192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD60297035) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 70957) |
| 208600000X Surgery (Licence: WA MD60297035) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2013-01-18 |