| NPI | 1073356036 |
|---|---|
| Former Name | CANDI JO HANNA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO 2024018524) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2024018524) |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |