| NPI | 1558892422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 5995) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 5995) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2018-03-21 |