| NPI | 1689255028 |
|---|---|
| Former Name | MARY ELIZABETH COPELAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036166884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02008517A) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2025-10-21 |