| NPI | 1720687833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2023-10-23 |