NPI | 1912311069 |
---|---|
Former Name | ASHLEIGH MARIE KRUEGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A140608) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-06-17 |
Last Update Date | 2020-01-06 |