NPI | 1437314127 |
---|---|
Former Name | TRACEY ERIN DURKOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME 2313) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OT012459) |
Enumeration Date | 2008-07-23 |
Last Update Date | 2013-12-10 |