NPI | 1346508363 |
---|---|
Former Name | SHAVONDA THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2015-01471) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TN 56231) |
207R00000X Internal Medicine (Licence: TN 56231) | |
Enumeration Date | 2012-04-27 |
Last Update Date | 2023-03-29 |