NPI | 1003182650 |
---|---|
Former Name | EMILY JANE RIVERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 29152) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-03-28 |
Last Update Date | 2019-08-19 |