NPI | 1073048807 |
---|---|
Former Name | KRISTY MICHELLE BEARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 89125) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 89125) |
Enumeration Date | 2017-04-30 |
Last Update Date | 2021-11-10 |