| NPI | 1154555746 | 
|---|---|
| Other Name | MARY RIDDELL DEAL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 14339)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 143684)  | 
| Enumeration Date | 2009-05-11 | 
| Last Update Date | 2009-05-11 |