| NPI | 1821293093 |
|---|---|
| Former Name | CONSTANCE LYNNE BELISSARY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 28803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239343) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2012-03-01 |