| NPI | 1700371580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 320656) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 275961) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-07-31 |