NPI | 1518968965 |
---|---|
Former Name | VICTORIA JEAN ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208800000X Urology (Licence: IA 31663) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 31663) |
Enumeration Date | 2005-08-09 |
Last Update Date | 2007-12-18 |