NPI | 1235109661 |
---|---|
Former Name | AMY NICOLE HAYES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101257774) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24077) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2023-02-28 |