| NPI | 1528696069 |
|---|---|
| Former Name | MATTALYNN RENETTE CHAVEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2021-04-19 |