| NPI | 1760634349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX N6478) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX TMBPIT#BP10025361) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2017-01-17 |