| NPI | 1639373277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WA MD60158478) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL16254) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2015-03-03 |