| NPI | 1750694618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD457783) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV AS22959042798) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT196835) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2021-11-17 |