| NPI | 1376956532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 308851) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD470315) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2021-07-01 |