NPI | 1619907656 |
---|---|
Former Name | JANE F WICZKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 24234) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 24234) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2021-05-29 |