| NPI | 1609197680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 443669) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 443669) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |