| NPI | 1144800913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX BP10084975) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: PA MT227160) | |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2026-05-22 |