| NPI | 1255894853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-02014) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 250065) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-07-22 |