NPI | 1619327335 |
---|---|
Former Name | LYNN RIESTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 77009) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 1769) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-14 |
Last Update Date | 2025-03-05 |