NPI | 1215342779 |
---|---|
Former Name | ALEXANDRIA UKLEJA KADOLPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01659) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 216979) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-06-24 |
Last Update Date | 2022-01-25 |