| NPI | 1467602367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25ma08284600) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 25MA08284600) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2012-05-17 |