| NPI | 1124134762 |
|---|---|
| Former Name | AMY MARIE CRAYCRAFT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 30432) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 58048) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-03-07 |