| NPI | 1710243811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MI 4301508170) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208C00000X Colon & Rectal Surgery (Licence: MO 2019033513) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2024-06-27 |