NPI | 1417377284 |
---|---|
Former Name | AMY LAURA JEMELKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60658904) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-21 |
Last Update Date | 2022-07-21 |