| NPI | 1952978363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116037113) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R78634) |
| Enumeration Date | 2021-06-06 |
| Last Update Date | 2022-07-08 |