| NPI | 1316324148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WV 35328) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 58487) |
| 2086S0129X (Licence: KY 58487) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2026-01-20 |