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Individual
MS. KATHERINE DIAZ VICKERY
Active
Individual
MS. KATHERINE DIAZ VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MSC
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301100106
MI
207Q00000X
Family Medicine Physician
Primary
52548
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2008
Last updated
01/28/2014
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