| NPI | 1164801346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X (Licence: TX W4996) |
| Additional Taxonomies | 2085N0700X (Licence: GA 88295) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2026-05-01 |