| NPI | 1619239613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MN 70005) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA BM6733807-Q141) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 184335) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME140972) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2021-09-28 |