NPI | 1578596029 |
---|---|
Former Name | NADINE SONJA HALLIBURTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 060079) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 27038) |
Enumeration Date | 2006-07-08 |
Last Update Date | 2018-07-05 |