| NPI | 1023539715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2017-08-18 |