NPI | 1659831386 |
---|---|
Former Name | CHRISTINE EILEEN DAVENPORT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD221691) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61183854) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2024-08-01 |