| NPI | 1114342318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS024786) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OS024786) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2026-05-21 |