| NPI | 1578682944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 86952) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301087755) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087755) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-04-26 |