NPI | 1720220650 |
---|---|
Former Name | ALICIA MARIE TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.010642) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34-010642) |
Enumeration Date | 2009-03-24 |
Last Update Date | 2020-12-04 |