NPI | 1346299492 |
---|---|
Former Name | LAURIE ANN BAILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 47700) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301099907) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2020-05-11 |