| NPI | 1316471014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT213272) |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 315570) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2024-08-14 |