| NPI | 1760972061 |
|---|---|
| Former Name | ALEXIS DANIELLE VICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-10-21 |