NPI | 1801421037 |
---|---|
Former Name | BRANDEE CATHLEEN MAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2024018581) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-09 |
Last Update Date | 2024-06-18 |