NPI | 1710753009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 1199439) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 1199439) |
Enumeration Date | 2023-11-28 |
Last Update Date | 2023-11-28 |