| NPI | 1770103517 |
|---|---|
| Other Name | SELENA TRICHEL PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102208029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 12337) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2025-04-16 |