NPI | 1801841960 |
---|---|
Former Name | ELIZABETH ANN TYRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD208773) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A65070) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2022-05-02 |