| NPI | 1669762209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 61407) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: MN TP109384) | |
| Enumeration Date | 2011-04-17 |
| Last Update Date | 2017-01-31 |