NPI | 1104880558 |
---|---|
Other Name | LORNA GAYE MCCOLLUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301-053445) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 053445) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2021-03-04 |