| NPI | 1811457310 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 73366)  | 
| Additional Taxonomies | 208VP0000X  (Licence: MN 73366)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 | 
| Last Update Date | 2023-06-22 |