| NPI | 1730522897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 68696) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT204362) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 62799) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2022-09-12 |