NPI | 1447590088 |
---|---|
Other Name | BEAU LACEFIELD |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5651) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO177881) |
207R00000X Internal Medicine (Licence: OH 34.012139) | |
207R00000X Internal Medicine (Licence: WA OP60641490) | |
Enumeration Date | 2013-02-19 |
Last Update Date | 2019-02-14 |