| NPI | 1659685279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR0064852) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 102306) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN15078) | |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2025-04-17 |