NPI | 1669733606 |
---|---|
Former Name | CHRISTINE DORMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 82449) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 1113) |
Enumeration Date | 2012-06-06 |
Last Update Date | 2022-01-12 |