| NPI | 1053738971 |
|---|---|
| Former Name | MARYANN SANDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2026-01035) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R4897) |
| 207Q00000X Family Medicine (Licence: FL ME147421) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2026-08-06 |