| NPI | 1174815765 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TX R4600) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX R4600) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-14 | 
| Last Update Date | 2018-03-17 |