| NPI | 1861735052 |
|---|---|
| Former Name | RICKLIE ANN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2016-05-09 |