| NPI | 1225562648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX U6697) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 390727607) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2024-01-09 |