NPI | 1225667397 |
---|---|
Former Name | KAYLA LAURINA HANSES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5151014443) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-02 |
Last Update Date | 2022-05-31 |