| NPI | 1184618746 |
|---|---|
| Former Name | VICKI MARIE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-050009) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301084923) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2012-05-31 |