| NPI | 1316475122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 71829) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2024-0533) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2024-06-06 |