| NPI | 1770921264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2019-00359) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 95404) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2025-08-15 |