| NPI | 1255781324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: MA 282847) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 267665) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2022-04-04 |