| NPI | 1033314794 |
|---|---|
| Former Name | TRACY RENEE POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine Adolescent Medicine (Licence: CA A108233) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD173883) |
| 207R00000X Internal Medicine (Licence: OR MD173883) | |
| 207R00000X Internal Medicine (Licence: CA A108233) | |
| 208000000X Pediatrics (Licence: CA A108233) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2018-07-01 |