| NPI | 1801021514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A122286) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A122286) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2023-04-28 |