| NPI | 1619230711 |
|---|---|
| Former Name | TABITHA LUCYNDA CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 9713A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO172351) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-07-17 |