NPI | 1295930543 |
---|---|
Former Name | JAMIE Y MANGRUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME120131) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME120131) |
Enumeration Date | 2007-06-18 |
Last Update Date | 2023-07-10 |