| NPI | 1093456774 |
|---|---|
| Former Name | JORDYN LYNN FRANCES HUSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2025018470) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-06-25 |