| NPI | 1235665001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 13955405-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 94048) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-07-18 |