| NPI | 1184987463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME139836) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: GA 79668) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2025-07-31 |