NPI | 1922505932 |
---|---|
Former Name | JERIKA HENNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.141663) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-07 |
Last Update Date | 2021-07-09 |