| NPI | 1093915480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX N6863) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP1-0028525) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP1-0028525) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2013-12-23 |