NPI | 1245686948 |
---|---|
Former Name | KARENA LYNN ROUNSAVILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60870282) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: WA ML60668457) | |
Enumeration Date | 2016-05-11 |
Last Update Date | 2021-06-09 |