NPI | 1316185838 |
---|---|
Former Name | VICTORIA RAE COBB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: SD 3474) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: SD 3474) |
Enumeration Date | 2009-01-22 |
Last Update Date | 2009-01-22 |