| NPI | 1780826677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D79735) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 277636) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2020-11-19 |