| NPI | 1164557252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MI 4301099406) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301099406) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2012-02-27 |