| NPI | 1124287545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MD d0074140) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: PA MT196280) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2026-07-08 |