NPI | 1730609587 |
---|---|
Former Name | ALAINA KLENE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61106781) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO206031) |
207Q00000X Family Medicine (Licence: MI 5101023450) | |
Enumeration Date | 2017-06-22 |
Last Update Date | 2024-05-20 |