NPI | 1184019879 |
---|---|
Former Name | KYLE DALTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 29633) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-03-31 |
Last Update Date | 2020-06-02 |