| 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 |