| NPI | 1710117312 |
|---|---|
| Former Name | MARISA ANN UPTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 12516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND LT12516) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2021-06-24 |