NPI | 1164659686 |
---|---|
Former Name | TRACY LYNN LIPPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-00261) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 249620) |
Enumeration Date | 2009-06-11 |
Last Update Date | 2014-07-14 |