| NPI | 1467655779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101263573) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085737) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085737) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2018-03-17 |