NPI | 1710273057 |
---|---|
Former Name | LILY JANE SHIPSEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60404330) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-06-24 |
Last Update Date | 2016-02-08 |