| NPI | 1972659647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME112412) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME112412) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-877) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-02-23 |