| NPI | 1699034603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NC 2018-00968) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-00968) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 183548) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2020-10-26 |