| NPI | 1861870255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WI 82090-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 82090-20) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107083) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2023-09-11 |