| NPI | 1801819578 |
|---|---|
| Former Name | FAYE BRADFISH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME139895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI WI52220-020) |
| 207Q00000X Family Medicine (Licence: FL vad0000) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME139895) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-03-25 |