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: VA 0101258407) |
207Q00000X Family Medicine (Licence: TN MD48253) | |
Enumeration Date | 2009-07-11 |
Last Update Date | 2024-06-26 |