| NPI | 1528420197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL OS20172) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10055358) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101026168) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2025-10-16 |