| NPI | 1164612370 |
|---|---|
| Former Name | COLETTE DEVONA TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 75415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS015213) |
| 207R00000X Internal Medicine (Licence: NJ 25MB08802400) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2022-10-08 |