| NPI | 1457105744 |
|---|---|
| Former Name | SAVANNAH JO DIMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 390200000X) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-06-09 |