| NPI | 1962964783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-54270) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-03-16 |