NPI | 1881155729 |
---|---|
Former Name | JORDYN FARRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 68084) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-25 |
Last Update Date | 2022-09-16 |