| NPI | 1770849440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD452643) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 293675) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2022-11-28 |