| NPI | 1528405636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 310127) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP02787) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP02787) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-06-21 |