| NPI | 1912401050 |
|---|---|
| Former Name | ERIKA L FENNEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 32173) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2021-07-12 |