| NPI | 1134347347 |
|---|---|
| Former Name | CAROL ANN REYBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101265405) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2007006297) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-11-02 |