| NPI | 1518173657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 47235) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301088315) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-03-12 |