| 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 |