| NPI | 1588854905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO 48792) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: MN 104264) | |
| 208600000X Surgery (Licence: MN 52232) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2012-11-06 |