| NPI | 1548607021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: MA 274585) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 201143) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 256456) | |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2025-09-29 |