| NPI | 1386027282 |
|---|---|
| Former Name | ERICA LYNN MANTERNACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05234) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2024-05-16 |