NPI | 1619231842 |
---|---|
Former Name | ANNA ROSE STANCZYK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301101273) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301101273) |
Enumeration Date | 2012-07-03 |
Last Update Date | 2015-05-20 |