| NPI | 1063779148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62428) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 174400000X Specialist (Licence: PA MT210538) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2018-03-17 |