NPI | 1194814913 |
---|---|
Former Name | TONYA JOAN JANSSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD22050) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00037571) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2007-07-08 |