NPI | 1992815815 |
---|---|
Former Name | AMBUR L STIDD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61337215) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N4963) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2022-12-14 |