| NPI | 1467089045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: MI 5101028674) | 
| Enumeration Date | 2020-03-24 | 
| Last Update Date | 2025-08-07 |