| NPI | 1326448879 |
|---|---|
| Former Name | CHANEL CHRISTINE SIMONICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |