| NPI | 1255777603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 83046) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 83046) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 244202) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2019-11-05 |