NPI | 1417941360 |
---|---|
Former Name | DEBORAH ONDERSMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 35505) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101011658) |
Enumeration Date | 2005-09-07 |
Last Update Date | 2018-01-26 |