NPI | 1124548631 |
---|---|
Former Name | LAUREN MARIE KLUTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 2594) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-06-26 |
Last Update Date | 2022-08-03 |