| NPI | 1134652506 |
|---|---|
| Former Name | BREANN KLUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.139487) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2020-08-26 |