NPI | 1841230893 |
---|---|
Former Name | TERRI L.M. JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301054368) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301054368) |
208100000X Physical Medicine & Rehabilitation (Licence: MI JJ054368) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2023-02-27 |