NPI | 1477559417 |
---|---|
Former Name | LARA E MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A9455) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2003001210) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2007-07-09 |