| NPI | 1588245435 |
|---|---|
| Former Name | JACQUELINE ANN CHAVEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CHAV-VXF0L4) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-09-16 |