| NPI | 1114547668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT220623) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT220623) |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2021-07-12 |