| NPI | 1821305301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 57454) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.012935) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.012935) | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2020-09-16 |