NPI | 1952091654 |
---|---|
Former Name | KARINA MARIE SANDEEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3868) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-05-08 |
Last Update Date | 2024-01-18 |