NPI | 1780076422 |
---|---|
Former Name | AMY MICHELLE BRUCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC DO37654) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 21417) |
Enumeration Date | 2015-03-03 |
Last Update Date | 2018-11-29 |