| NPI | 1679150650 |
|---|---|
| Former Name | ELYSE LYNNETTE MCBRIDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 72267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31619) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-08-12 |