| NPI | 1922662592 |
|---|---|
| Former Name | KAITLUND RAKEL TANGVALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61242890) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2022-06-01 |