| NPI | 1831572767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: KS 0444887)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX S4783)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN21716)  | |
| Enumeration Date | 2015-07-09 | 
| Last Update Date | 2024-12-23 |