| NPI | 1063570620 |
|---|---|
| Former Name | RUBY MARIE NORTHRUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 233) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-07-26 |