| NPI | 1679816961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME151245) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME151245) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: OH 35.133699) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2024-11-19 |