| NPI | 1740613629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX W0362) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 1828418) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: SC 94191) | |
| 208600000X Surgery (Licence: VA 0101277902) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2025-10-01 |