| NPI | 1154693794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 537595111) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 537595111) |
| Enumeration Date | 2012-01-28 |
| Last Update Date | 2012-01-28 |