NPI | 1093969735 |
---|---|
Former Name | SHAWNA BOUWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.097076) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD441533) |
Enumeration Date | 2008-11-07 |
Last Update Date | 2016-12-28 |