NPI | 1669418935 |
---|---|
Former Name | SHEILA BENITIA TRIPLETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02003529A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 1591) |
207Q00000X Family Medicine (Licence: OK 3996) | |
Enumeration Date | 2006-06-22 |
Last Update Date | 2022-08-03 |