NPI | 1043572126 |
---|---|
Former Name | CAROLYN N SANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.137804) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.061228) |
Enumeration Date | 2012-06-13 |
Last Update Date | 2017-06-05 |