| NPI | 1952591711 |
|---|---|
| Former Name | MA THERESA CONCEPCION |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60120609) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301089956) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2012-07-30 |