| NPI | 1215627609 |
|---|---|
| Former Name | CARLY SHAYLA CLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10085700) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-10 |