| NPI | 1467947564 |
|---|---|
| Former Name | KATRINA LEE TANK LYBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND RL15235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 16641) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2022-08-16 |