| NPI | 1417216342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: MA 293706) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2023-11-25 |