NPI | 1720254972 |
---|---|
Former Name | JAMIE ETZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS014252) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012233) |
207R00000X Internal Medicine (Licence: WV 2198) | |
Enumeration Date | 2008-05-07 |
Last Update Date | 2022-04-06 |