NPI | 1407981814 |
---|---|
Former Name | ALISHA B KETNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO126006) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR DO126006) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2012-11-29 |