NPI | 1255998894 |
---|---|
Former Name | MARION COPELAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101272157) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-05-20 |
Last Update Date | 2024-06-03 |