| NPI | 1649690553 |
|---|---|
| Former Name | VANESSA BERNICE VIDALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |