| NPI | 1770635062 |
|---|---|
| Former Name | DEEDRA G CORZART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036107216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036107216) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-12-28 |