| NPI | 1194972091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO 52180) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R8395) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2014-10-24 |