| NPI | 1427790823 |
|---|---|
| Former Name | THERESA ABIGAIL BERGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-06-16 |