NPI | 1972992865 |
---|---|
Former Name | EVGENIA KHODUKINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG-0012241) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0043992) |
Enumeration Date | 2015-01-14 |
Last Update Date | 2022-12-12 |