| NPI | 1023066677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA C53924) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35091332) |
| 208600000X Surgery (Licence: WI 44951) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA C53924) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: OH 35091332) | |
| 2086S0127X Surgery Trauma Surgery (Licence: CA C53924) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 44951) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-03-20 |