| NPI | 1740419746 |
|---|---|
| Former Name | PEGGY SUE CAVITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 48253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD48253) |
| 207Q00000X Family Medicine (Licence: VA 0101258407) | |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2023-03-23 |