| NPI | 1033861851 |
|---|---|
| Former Name | MARY GRACE THETFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 39482) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-01-23 |
| Last Update Date | 2022-06-09 |