| NPI | 1669821492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: SC 88295) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL399764) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2022-09-02 |