| NPI | 1508393455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301514648) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 009066) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301514648) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA GA009066) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2025-08-13 |