| NPI | 1063915718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 17-43275) |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2021-09-16 |