| NPI | 1508021536 |
|---|---|
| Former Name | LATONYA ANTOINETTE RIDDLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301092759) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301092759) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2021-10-19 |