NPI | 1235659640 |
---|---|
Former Name | KELLY MARGARET REDLINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 90534) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 86312) |
207Q00000X Family Medicine (Licence: SC LL51166) | |
Enumeration Date | 2017-06-27 |
Last Update Date | 2024-01-16 |