| NPI | 1659638187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 294339-1) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 294339-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2021-05-13 |