| NPI | 1003962655 |
|---|---|
| Former Name | ELIZABETH AMY KOSANKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA BC60332422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A89215) |
| 225700000X Massage Therapist (Licence: WA MA61457610) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-04-21 |