| NPI | 1700974219 |
|---|---|
| Former Name | JOAN DONNA MARIE BOWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD14475) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00025388) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-26 |