NPI | 1912042557 |
---|---|
Former Name | JULIE ANN RACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101015420) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6362009380) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2021-07-23 |