NPI | 1750336103 |
---|---|
Other Name | K. RAE AMBROZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036103211) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 6650A) |
207Q00000X Family Medicine (Licence: NC 9801139) | |
Enumeration Date | 2006-05-24 |
Last Update Date | 2023-03-21 |