NPI | 1457807323 |
---|---|
Former Name | KAITLIN BRAUN REUSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MT 51053) | |
Enumeration Date | 2016-08-30 |
Last Update Date | 2023-07-13 |