| NPI | 1750904629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.257718) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A186882) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2025-06-03 |