NPI | 1881830776 |
---|---|
Former Name | AMBER LYNN MCINTOSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A101464) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036134569) |
Enumeration Date | 2008-12-23 |
Last Update Date | 2021-11-09 |