| NPI | 1992026751 |
|---|---|
| Former Name | TERESA DAWN MINCHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME114497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD205827) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2019-06-25 |