| NPI | 1114661774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R79283) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R79283) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-12-07 |