| NPI | 1023466570 |
|---|---|
| Former Name | MALLORY KIMSEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 84754) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 208D00000X) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2020-10-20 |