| NPI | 1235549890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 68142) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2019-0447) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-10-19 |