| NPI | 1336113091 |
|---|---|
| Former Name | TRACY LYNN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0061629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD039258) |
| 207Q00000X Family Medicine (Licence: VA 0101250064) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-05-27 |