| NPI | 1295250520 |
|---|---|
| Former Name | MAGGIE DITMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT 097.0136416) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2025-12-04 |