NPI | 1003103771 |
---|---|
Former Name | KATELYN VIRGINIA BRASWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 32551) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2011-07-01 |
Last Update Date | 2021-03-25 |