| NPI | 1710566088 |
|---|---|
| Former Name | MAKENNA RICKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 8440) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102207487) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2024-07-23 |