| NPI | 1194143180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 306288-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: TX S1250) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2020-09-09 |