NPI | 1518386283 |
---|---|
Former Name | MARY ANN ROSEVEAR LESCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101276442) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 67341) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2022-12-14 |