| NPI | 1033606157 |
|---|---|
| Former Name | BROOKE ALEXANDRA JENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MN 68573) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2022-08-03 |