| NPI | 1104446103 |
|---|---|
| Former Name | TRACEY LOCKHART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-15558) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301509873) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2025-07-02 |