| NPI | 1487911913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 67789) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 60075) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2022-07-21 |