NPI | 1215967849 |
---|---|
Former Name | GINA M. BAILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 15-00947) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 0425245) |
Enumeration Date | 2006-07-03 |
Last Update Date | 2022-06-01 |