| NPI | 1770043903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 68777) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 68777) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 244202) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2021-05-12 |