| NPI | 1184930455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CT 66471) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096855) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 57453) | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2020-09-21 |