| NPI | 1972733913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OT013209) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS15381) |
| 208600000X Surgery (Licence: MD H0079472) | |
| 208C00000X Colon & Rectal Surgery (Licence: FL OS15381) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2022-01-28 |