| NPI | 1114243094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD047358) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 164703) |
| 208600000X Surgery (Licence: MD D0085530) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2019-10-24 |