NPI | 1982916896 |
---|---|
Former Name | AUDREY B RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50473) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096247) |
Enumeration Date | 2010-07-08 |
Last Update Date | 2015-03-30 |