| NPI | 1427813237 |
|---|---|
| Former Name | AUTUMN BROOKE NETHERCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |