NPI | 1558637991 |
---|---|
Former Name | KRISTA JOY WILLINGHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.016360) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q4547) |
Enumeration Date | 2012-03-29 |
Last Update Date | 2023-06-07 |