| NPI | 1194075861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME150959) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S0586) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2021-09-17 |