| NPI | 1396185666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: FL ME136800) |
| Additional Taxonomies | 2085R0001X (Licence: AL 33689) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2025-05-16 |