| NPI | 1629503495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: FL ME170541) |
| Additional Taxonomies | 2085R0001X (Licence: IL 036160933) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2025-04-03 |