| NPI | 1013406719 |
|---|---|
| Former Name | JESSICA BUTIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CO PN.0332845) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |