NPI | 1023578945 |
---|---|
Former Name | KALEY GARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61423802) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11899044-1204) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-08-08 |