| NPI | 1942265145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 9068926-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 965-TEP) |
| 208600000X Surgery (Licence: UT 9068926-8905) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 50432) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-10-20 |