| NPI | 1861982761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 34.017403) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.017403) |
| 208C00000X Colon & Rectal Surgery (Licence: MI 5101027397) | |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2025-03-20 |