NPI | 1548688765 |
---|---|
Former Name | BRITANNE JANELL SOCKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101263648) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD468585) |
207Q00000X Family Medicine (Licence: NJ 25MA10677) | |
207Q00000X Family Medicine (Licence: MD d0082899) | |
Enumeration Date | 2014-04-04 |
Last Update Date | 2023-11-13 |