NPI | 1104937093 |
---|---|
Former Name | MARA WELLS VOLKOMMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60170884) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML20008684) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2010-11-19 |