| NPI | 1225472095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WV IN0006476) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD ST11453) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |