NPI | 1972878627 |
---|---|
Former Name | SWAN OSHANA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 053820) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-03-14 |
Last Update Date | 2021-06-22 |