| NPI | 1801336565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1034883162) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 1279832) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2019-08-21 |