| NPI | 1023246915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SD 9376) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301095068) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301095068) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2014-12-09 |