| NPI | 1316686694 |
|---|---|
| Former Name | EBONY MARIE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351049069) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2023-01-11 |