NPI | 1265692123 |
---|---|
Former Name | CHERIE O SIU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 48556) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036128438) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125055005) | |
Enumeration Date | 2008-06-13 |
Last Update Date | 2020-12-02 |