NPI | 1508356650 |
---|---|
Former Name | SHAYLAGH MAY MCCOLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 286397) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 275828) |
Enumeration Date | 2018-05-15 |
Last Update Date | 2021-07-02 |