NPI | 1487661666 |
---|---|
Former Name | LORNA DIANNE SHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2005034478) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-0-78975) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2023-03-07 |