| NPI | 1033479308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 550415111) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 550381111) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2013-06-18 |