| NPI | 1982864690 |
|---|---|
| Former Name | MALLORIE J. EVENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2015-03-05 |