NPI | 1467949685 |
---|---|
Former Name | KAITLYN MAE GREENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4351046684) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-13 |
Last Update Date | 2020-05-28 |