| NPI | 1699061218 |
|---|---|
| Former Name | MISTEE MICHELLE RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-37623) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2011017922) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-10-22 |