| NPI | 1205365731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID O-1862) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 19534) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101023316) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2023-08-30 |