| NPI | 1871027821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC PORT-38WRK1) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227142) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-03-14 |