| NPI | 1689060956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 86651) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 209897) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-09-20 |