NPI | 1548720980 |
---|---|
Former Name | CAMILLE LUCJAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 89697) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-21 |
Last Update Date | 2023-08-21 |