NPI | 1083842272 |
---|---|
Former Name | AMY C FOUTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M11156) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60275737) |
Enumeration Date | 2009-06-25 |
Last Update Date | 2014-01-15 |