| NPI | 1346696077 |
|---|---|
| Former Name | MACKENZIE GLEE KALIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62723) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.068199) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.068199) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2022-07-21 |