| NPI | 1992148332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: OH 57.023289) |
| Additional Taxonomies | 2085R0001X (Licence: ID M-15656) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-04-13 |