NPI | 1053892109 |
---|---|
Former Name | JANESSA LYNN BLASER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG61001199) |
Enumeration Date | 2018-08-27 |
Last Update Date | 2019-11-21 |