| NPI | 1437220241 |
|---|---|
| Former Name | MARY LOUISE MARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI MI5101012165) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC TL-1033) |
| 207Q00000X Family Medicine (Licence: CO CO 40167) | |
| 207Q00000X Family Medicine (Licence: OH 34-008880) | |
| 207Q00000X Family Medicine (Licence: IN 02003339A) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-11-25 |