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 |