| NPI | 1104073808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MD D0071690) |
| Additional Taxonomies | 2086S0129X (Licence: NY 240138) |
| 2086S0129X (Licence: WI 66641) | |
| 2086S0129X (Licence: PA MD425161) | |
| 2086S0129X (Licence: MA 241003) | |
| 2086S0129X (Licence: GA 072852) | |
| 2086S0129X (Licence: FL ME121025) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 240138-1) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 240138) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2019-11-14 |