| NPI | 1962767632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: NY 298364) |
| Additional Taxonomies | 2086S0129X (Licence: TX R0611) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-02-23 |