NPI | 1124289285 |
---|---|
Former Name | VICTORIA ASBURY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01013) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN DO0000002241) |
207Q00000X Family Medicine (Licence: VA 0116020620) | |
Enumeration Date | 2008-06-21 |
Last Update Date | 2020-10-25 |