| NPI | 1730740820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 105636) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 8568) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-08-19 |