| NPI | 1871325530 |
|---|---|
| Former Name | ALIYA SUSAN GRINDSTAFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 21281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 34732) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |