NPI | 1063646974 |
---|---|
Former Name | KRISTIN MICHELLE POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D76428) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156929) |
Enumeration Date | 2009-05-06 |
Last Update Date | 2018-03-17 |