NPI | 1396731410 |
---|---|
Former Name | MICHELLE A THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 51829) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD23927) |
Enumeration Date | 2005-09-23 |
Last Update Date | 2023-03-07 |