NPI | 1336643980 |
---|---|
Former Name | KIM ELIZABETH BAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61081956) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-03-20 |
Last Update Date | 2021-04-05 |