| NPI | 1538699533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PR 23700) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME163110) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-09-24 |