| NPI | 1609068188 |
|---|---|
| Former Name | KATIE JEAN CARPENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: FL ME100130) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN8006) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2021-06-11 |