| NPI | 1588164040 |
|---|---|
| Former Name | ERICA ANN BEAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY TL6839) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-02-15 |