| NPI | 1629428032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX BP20077228) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110360) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN25439) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2021-07-07 |