| NPI | 1922457738 |
|---|---|
| Former Name | KAITLIN MARIE BRUEGENHEMKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2019030501) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016018002) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2023-06-28 |