| NPI | 1134410004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 300027) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198851) |
| 208600000X Surgery (Licence: PA MT198851) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2021-02-18 |