| NPI | 1154680254 |
|---|---|
| Former Name | LEILA MARIE LOGUE |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 274054) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 274054) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2025-01-22 |