NPI | 1114506490 |
---|---|
Former Name | AMANDA MEGAN KARASIC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 76502) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-04-05 |
Last Update Date | 2024-06-24 |