NPI | 1114452703 |
---|---|
Former Name | JORDYN GABRIELLE SUHR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58032915) |
Enumeration Date | 2017-04-21 |
Last Update Date | 2022-04-26 |