| NPI | 1992252449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 84105) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125075487) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: PA MT223294) | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2026-07-30 |