| NPI | 1619396785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID O-1263) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 1619396785) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2025-03-13 |