| NPI | 1457799918 |
|---|---|
| Former Name | MARY BEGOLE NORDSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 27631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.129860) |
| 207P00000X Emergency Medicine (Licence: MS 23295) | |
| 207P00000X Emergency Medicine (Licence: CA G85620) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2022-07-21 |