| NPI | 1770719726 |
|---|---|
| Former Name | CASSIE JEAN BACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-04106) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA DO-04106) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2023-10-25 |