NPI | 1114553013 |
---|---|
Former Name | CARMEN RAE BOESSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL me168795) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 70002) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-09-09 |