| NPI | 1689960346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX BP10048721) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198692) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2014-06-23 |