NPI | 1053863803 |
---|---|
Former Name | KAREN DONNIE DEVANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171000000X Military Health Care Provider (Licence: NC PHYP 7414) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: AK PHYP 1761) |
Enumeration Date | 2016-10-27 |
Last Update Date | 2025-03-14 |