| NPI | 1457808578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 1018090) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 289652) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL B22001994678) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2024-07-23 |