| NPI | 1619408234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 298555) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA11829800) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-09-30 |