| NPI | 1710419924 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: WV 34346)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 2086S0102X Surgery, Surgical Critical Care (Licence: WV 34346)  | |
| Enumeration Date | 2017-03-28 | 
| Last Update Date | 2025-07-17 |