| NPI | 1619539095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351054112) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2025-05-07 |