NPI | 1619972999 |
---|---|
Former Name | DAWN M EVERHART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036099085) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-0099085) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2021-04-21 |