NPI | 1407816531 |
---|---|
Former Name | LISA ROBYN DEVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0068510) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 39756) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2022-08-16 |