| NPI | 1780881862 |
|---|---|
| Former Name | COURTNEY STANNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 63919) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 63919) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2011-05-19 |