| NPI | 1821357575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 0397) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 0397) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |