| NPI | 1700324738 |
|---|---|
| Former Name | SARA JANE BUBENIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2019020548) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2023-08-09 |