| NPI | 1831117829 |
|---|---|
| Former Name | JANICE RENAE MANCOTTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 16317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 1680) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-06-16 |