| NPI | 1639379936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301107939) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MI 4301107939) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2021-04-22 |