| NPI | 1477714871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: TX Q0428) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 250991) |
| 207L00000X Anesthesiology (Licence: TX Q0428) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193256) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-02-12 |