NPI | 1356961296 |
---|---|
Former Name | OLIVIA OSBORNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 4134) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-21 |
Last Update Date | 2023-08-09 |