| NPI | 1881154904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD491224) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R78057) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-07-29 |