NPI | 1003103888 |
---|---|
Former Name | AMELIA LASKOWSKI WRIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101020173) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: MI 5101020173) |
Enumeration Date | 2011-06-30 |
Last Update Date | 2023-03-23 |