| NPI | 1114285988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 298707) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 16713) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2021-12-20 |