| NPI | 1720188477 |
|---|---|
| Former Name | CANDY L P VORDERBRUG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NM MD2020-0642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 42413) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2023-02-09 |