NPI | 1558083659 |
---|---|
Former Name | JACOB OVERDURFF |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 088938-21) |
Enumeration Date | 2022-09-15 |
Last Update Date | 2022-09-15 |