| NPI | 1639388879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX N7637) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10016879) | 
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2010-12-02 |