NPI | 1174719587 |
---|---|
Former Name | DARLA L RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO151900) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL20000126) |
207Q00000X Family Medicine (Licence: NV DO3262) | |
Enumeration Date | 2007-09-19 |
Last Update Date | 2022-09-22 |