| NPI | 1114307097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 326636) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT209454) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2022-05-19 |