| NPI | 1902298862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA Speech Language Path) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |