| NPI | 1760725147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD225158) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: OR MD225158) |
| 208C00000X Colon & Rectal Surgery (Licence: KY 54268) | |
| 208600000X Surgery (Licence: KY 54268) | |
| 208C00000X Colon & Rectal Surgery (Licence: KY TP364) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2026-06-11 |