| NPI | 1669887873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M-16519) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 64688-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2022-05-10 |