NPI | 1003296724 |
---|---|
Former Name | MOLLY M LUNSTRUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1008) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRO-1478) |
Enumeration Date | 2015-06-08 |
Last Update Date | 2023-12-15 |