| NPI | 1982903480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 268374) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q9750) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2023-04-24 |