NPI | 1376787937 |
---|---|
Former Name | ALISHA R. MCCON-DYER-REPLACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A11439) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-04-27 |
Last Update Date | 2012-10-15 |