NPI | 1295021079 |
---|---|
Former Name | KATRINA LYNN GUCKENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 735-00) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101252351) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2024-04-11 |