| NPI | 1659908473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WI 87631-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301514904) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: IL 125.076024) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-07-23 |