NPI | 1861748717 |
---|---|
Former Name | VICKY KOSAKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL OS13399) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS13399) |
208D00000X General Practice (Licence: FL uo3299) | |
Enumeration Date | 2012-07-30 |
Last Update Date | 2022-06-17 |