NPI | 1992116610 |
---|---|
Former Name | AUTUMN DAWN METZGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD192399) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 276876) |
Enumeration Date | 2014-05-15 |
Last Update Date | 2021-03-09 |