NPI | 1770759706 |
---|---|
Former Name | CHRISTINA LOUISE HECKATHORN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 1197) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58-001449) |
Enumeration Date | 2008-04-30 |
Last Update Date | 2010-06-16 |