| NPI | 1861855850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 341529) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 9177) |
| 208600000X Surgery (Licence: IL 999999999) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-05-08 |