| NPI | 1730533654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A176342) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 95622) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2023-08-24 |