NPI | 1275557928 |
---|---|
Former Name | PATRICIA ANN VAN SLYKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00045633) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 45633) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2021-04-28 |