NPI | 1326204769 |
---|---|
Former Name | ELAINE MARGARET CARLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 16469) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11014532A) |
Enumeration Date | 2008-08-05 |
Last Update Date | 2014-12-01 |