| NPI | 1467776401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60551208) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2021-03-18 |