| NPI | 1972002780 |
|---|---|
| Former Name | BIANCA BUSTAMANTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 12007) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 12007) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2021-02-05 |