| NPI | 1275929069 |
|---|---|
| Former Name | ELIZABETH PEARL WANOUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 11093) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: SD 243) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-09-17 |