| NPI | 1770801870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A158679) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA mt210927) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2020-11-12 |