| NPI | 1790290096 |
|---|---|
| Former Name | LEEANNE MICHELE STOREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PAC-LIC-60753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-60753) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2020-05-29 |