| NPI | 1851336325 |
|---|---|
| Former Name | ANDREA SHAE HEROLD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2012013484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23567) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2017-03-14 |