NPI | 1982232161 |
---|---|
Former Name | KATLIN MATTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72405) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-01 |
Last Update Date | 2023-06-09 |