| NPI | 1912616160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2022-11-16 |