| NPI | 1417571779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 104763-01) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2025-09-18 |