| NPI | 1306692074 |
|---|---|
| Former Name | MARY MADISON CALLAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-12-23 |