| NPI | 1639464829 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AZ 61276)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2011-06-15 | 
| Last Update Date | 2023-10-31 |