NPI | 1811438393 |
---|---|
Former Name | LENA BAZHENOVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0062434) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0006407) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0006407) | |
Enumeration Date | 2017-03-16 |
Last Update Date | 2021-10-07 |