| NPI | 1942881107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: WI 85342-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX BP10074271) | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2026-06-23 |