| NPI | 1144991688 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 109642)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: IA 109642)  | 
| Enumeration Date | 2021-09-24 | 
| Last Update Date | 2021-09-24 |