| NPI | 1356545172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR DO197101) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0060328) |
| 208600000X Surgery (Licence: VA 0102203873) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-11-02 |