| NPI | 1609620004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 58.034151) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-06-04 |