| NPI | 1205415700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2026-02555) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2026-02555) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2026-06-29 |