| NPI | 1356760748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 323219) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10631100) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-10-31 |