NPI | 1598008195 |
---|---|
Former Name | AMANDA J GAWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0056765) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-02 |
Last Update Date | 2020-04-24 |