| NPI | 1255015053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MI 4351051998) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351051998) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2024-06-05 |