| NPI | 1932567633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 6119) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2023-04-18 |