NPI | 1760821656 |
---|---|
Former Name | MEGAN HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 75335) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3619) |
Enumeration Date | 2013-06-24 |
Last Update Date | 2020-08-05 |