| NPI | 1336572718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301104175) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301104175) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2016-04-15 |