| NPI | 1740576339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WI 73480-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 73480-20) |
| 208600000X Surgery (Licence: IL 125.059360) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2021-02-04 |