| NPI | 1942563184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T1439) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 261313) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-07-28 |