| NPI | 1487394870 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health | 
| Enumeration Date | 2022-04-01 | 
| Last Update Date | 2025-04-02 |