NPI | 1659666139 |
---|---|
Former Name | CHERYL-LYNNE DEIDRE ARCHIBALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203396) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102203396) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0102203396) | |
Enumeration Date | 2011-06-13 |
Last Update Date | 2025-05-14 |