| NPI | 1487961090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X (Licence: VA 0101260160) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-017926) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2016-07-07 |