NPI | 1699189332 |
---|---|
Former Name | AMY SHOEMYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-144576) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2017018224) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2023-11-27 |