| NPI | 1649774803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 125.075408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2020-06-23 |