| NPI | 1205222072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 0000065907) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.140892) |
| 208600000X Surgery (Licence: NH 20218) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-09-16 |