| NPI | 1568017762 |
|---|---|
| Former Name | KATIE DEANNE CLOUD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ME PA2188) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2021-06-29 |