NPI | 1912389735 |
---|---|
Former Name | MAGGIE F CASTILE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 29671) |
Additional Taxonomies | 171000000X Military Health Care Provider |
Enumeration Date | 2015-06-29 |
Last Update Date | 2021-07-30 |