| NPI | 1720878556 |
|---|---|
| Former Name | GRACE KATHRYN FIRESTINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-07-06 |