| NPI | 1124642368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: TX V8245) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R78132) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2025-10-31 |