NPI | 1467814954 |
---|---|
Former Name | SAMANTHA DUSEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 15261) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14147) |
Enumeration Date | 2016-03-23 |
Last Update Date | 2020-06-24 |