| NPI | 1780268185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301514971) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301514971) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351047552) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2026-05-29 |