| NPI | 1285825687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX N9002) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA MD.201533) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2012-04-24 |