| NPI | 1083061832 |
|---|---|
| Former Name | KAITLIN REBECCA COOPERSTEIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301119331) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2019-09-06 |