| NPI | 1083914261 |
|---|---|
| Former Name | KORTNI R COKELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 7414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005908) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2020-01-06 |