| NPI | 1912296427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10061900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 284068) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2022-07-21 |