| NPI | 1770762585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PR 17945) |
| Additional Taxonomies | 208600000X Surgery (Licence: PR 17945) |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME113662) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 42450) | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2014-10-01 |