| NPI | 1134565096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 93048) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA C159352) |
| 208D00000X General Practice (Licence: NC 2014-01826) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2024-08-27 |