| NPI | 1063949741 |
|---|---|
| Other Name | LEIGH MAE JOANNE GISELE ROSA PROVENCHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 83019) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2020-0448) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2024-05-15 |