| NPI | 1598990467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 314041-01) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC tbd) |
| 208600000X Surgery (Licence: CA A121328) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301109184) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2022-06-28 |