| NPI | 1972117018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084E0001X (Licence: MN 76664) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 8930) |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2024-10-07 |