| NPI | 1699187948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.145849) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX T0291) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-01-12 |