| NPI | 1932163110 |
|---|---|
| Former Name | DEANNE K ECCLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WI 40546-020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 40546-020) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-11-11 |