| NPI | 1275519563 |
|---|---|
| Former Name | DEBORAH MANGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 25696) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 25696) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2021-03-17 |