NPI | 1730470451 |
---|---|
Former Name | SYDNEY LANE VONK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4426) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-04-28 |
Last Update Date | 2016-09-02 |