NPI | 1922096205 |
---|---|
Former Name | ALICE GWYN MCCORMICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 78634) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2010-07-23 |