NPI | 1356795421 |
---|---|
Former Name | JESSICA ECKSTROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CO dr.0069093) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-14 |
Last Update Date | 2023-06-07 |