| NPI | 1104500644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 81627) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 100132-851) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2024-09-12 |