| NPI | 1114027513 |
|---|---|
| Former Name | DEDRA LEANN THRASH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 1-093350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-093350) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2014-06-18 |