| NPI | 1194384503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX V0454) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5151014024) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-05-06 |