| NPI | 1164899746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2015-09-08 |