| NPI | 1407238595 |
|---|---|
| Former Name | YENNY PURNAWAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 746445) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |