NPI | 1962820100 |
---|---|
Former Name | COLLEEN QUINN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-82860) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 295871) |
207Q00000X Family Medicine (Licence: IL 036142994) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-04 |
Last Update Date | 2021-04-29 |