| NPI | 1205499209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 79920) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 34856) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-07-31 |