| NPI | 1447609375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11599900) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MTL004904) |
| 208600000X Surgery (Licence: MA 268407) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2023-11-15 |