| NPI | 1831762673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESSICA HARDY Ms. 228-641-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2021-07-20 |