| NPI | 1275948242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 849276883) | 
| Enumeration Date | 2014-06-27 | 
| Last Update Date | 2014-08-12 |