| NPI | 1154785426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5151011248) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101024197) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2023-06-01 |