| NPI | 1720240062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R4840) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036142531) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1904) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2020-09-02 |