NPI | 1932595600 |
---|---|
Former Name | ALANA MOUERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: OR DO194476) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO194476) |
207Q00000X Family Medicine (Licence: WA OL60567569) | |
Enumeration Date | 2015-04-09 |
Last Update Date | 2023-11-20 |