| NPI | 1760778500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T2946) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT210086) |
| 208600000X Surgery (Licence: VA 0101255025) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: PA MD455479) | |
| 208600000X Surgery (Licence: NY 278193) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-12-09 |