| NPI | 1770074908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 3015363) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2023-06-13 |