NPI | 1558629204 |
---|---|
Former Name | COURTNEY A ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017651) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: NY 272635) | |
Enumeration Date | 2012-05-01 |
Last Update Date | 2015-06-12 |