NPI | 1710417498 |
---|---|
Former Name | RACHEL ALLYN FENTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.016466) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL51236) |
Enumeration Date | 2017-06-15 |
Last Update Date | 2023-08-04 |