NPI | 1235193137 |
---|---|
Former Name | TERESA I CANDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 44824) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 44824-20) |
Enumeration Date | 2006-04-17 |
Last Update Date | 2024-06-18 |