| NPI | 1548094311 |
|---|---|
| Former Name | BANIBAJA CLHAVINZKY THERESIA SILALAHI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CO RBT-22-217639) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-08-26 |