NPI | 1225534100 |
---|---|
Former Name | CHELSIE LEE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 100349) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-100349) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-01 |
Last Update Date | 2024-02-19 |