| NPI | 1750579876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA RN 167681 CNS/PMH) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |