| NPI | 1104201086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080H0002X (Licence: TN 62346) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 263439) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2025-02-17 |