| NPI | 1790054575 |
|---|---|
| Former Name | ANN VERSAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 378647) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |