| NPI | 1205827169 |
|---|---|
| Former Name | RAE RICHARDSON, TYE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR. 0051917) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 063449) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2016-09-23 |