| NPI | 1790852119 |
|---|---|
| Former Name | DIANNA MICHELLE CHASE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 21427) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009001737) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2023-12-29 |