| NPI | 1306587639 |
|---|---|
| Former Name | GRETTA MAE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |