| NPI | 1003268129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301500919) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110604) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2023-09-07 |