| NPI | 1962864165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD479371) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: IL 036.155457) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-12-20 |