NPI | 1316916265 |
---|---|
Former Name | COURTNEY S LUCADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME97574) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 01012333389) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2013-06-11 |