NPI | 1578267464 |
---|---|
Former Name | MARINA TKACHENKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MDRE.ML.61425809) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-03-27 |
Last Update Date | 2023-03-27 |