| NPI | 1073041141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME169162) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN36590) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2025-08-05 |