NPI | 1154784593 |
---|---|
Former Name | TAMRA JOY RICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A162430) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-02 |
Last Update Date | 2019-09-07 |