| NPI | 1255885935 |
|---|---|
| Former Name | JESSICA BANDELOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2017-06-19 |