NPI | 1639437213 |
---|---|
Former Name | AYANNA AMLAK KHALSA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME123016) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-05-02 |
Last Update Date | 2015-08-03 |