| NPI | 1477029106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 7637) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7637) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2019-11-11 |