NPI | 1881868008 |
---|---|
Former Name | SHERRIE LYNN BALLANTINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0051809) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CO DR.0051809) |
Enumeration Date | 2008-04-18 |
Last Update Date | 2024-06-27 |