NPI | 1407021173 |
---|---|
Former Name | JACQUELINE Q BOWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155925) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-02593) |
Enumeration Date | 2008-04-24 |
Last Update Date | 2022-05-13 |