| NPI | 1972915809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME145053) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 286510) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2022-01-13 |