| NPI | 1609166180 |
|---|---|
| Former Name | MARA CAROLINE BACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA 05104) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 006459) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2021-01-29 |