| NPI | 1073703542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2015022428) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.033274) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2023-04-13 |