| NPI | 1780905802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD464797) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 77371) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2020-05-22 |