| NPI | 1043081060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2026-08-03 |