| NPI | 1962639963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CT 50518) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 50518) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2012-01-18 |