NPI | 1750589024 |
---|---|
Former Name | VICKY L POUCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2007013967) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2007013967) |
207Q00000X Family Medicine (Licence: MO 2007013987) | |
Enumeration Date | 2007-07-06 |
Last Update Date | 2022-12-16 |