| NPI | 1891082269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 287403) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 017234-01) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-06-05 |