| NPI | 1326381914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 71647) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 66308) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103690) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-09-14 |