| NPI | 1912119991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101237416) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116014789) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-06-01 |