| NPI | 1295239721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: IL 036.153530) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: IL 125.073068) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-05-24 |