NPI | 1164522785 |
---|---|
Former Name | LYNN A BEATTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD197669) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301061662) |
207Q00000X Family Medicine (Licence: WA MD61187277) | |
Enumeration Date | 2006-09-24 |
Last Update Date | 2021-08-11 |