| NPI | 1659720225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: KS 94-09332) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301109971) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-04-26 |