NPI | 1003893785 |
---|---|
Former Name | JETUAN L ROWLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2004020480) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-111984) |
207QS0010X Family Medicine, Sports Medicine (Licence: IL 036.111984) | |
Enumeration Date | 2005-12-23 |
Last Update Date | 2013-12-30 |