| NPI | 1053503730 |
|---|---|
| Former Name | CHAVON MARIA BLACKBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD038745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 51420) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2011-07-04 |