| NPI | 1992234405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 271906) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2025-0018) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2025-06-17 |