NPI | 1992383160 |
---|---|
Former Name | TAYLOR LAINE ERNEST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0072847) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 72288) |
207Q00000X Family Medicine (Licence: MN 31581) | |
Enumeration Date | 2021-03-30 |
Last Update Date | 2024-07-11 |