| NPI | 1255873188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 333464) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 023763) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2024-10-24 |