| NPI | 1366603607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD52701) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 150326) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-03-29 |