NPI | 1679763882 |
---|---|
Former Name | ERICA JOY TULL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101017347) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017347) |
Enumeration Date | 2007-07-25 |
Last Update Date | 2020-07-17 |