NPI | 1003867037 |
---|---|
Former Name | JENNIE KAY WALKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 10784) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M9143) |
Enumeration Date | 2006-05-15 |
Last Update Date | 2008-05-12 |