NPI | 1275996324 |
---|---|
Former Name | CHELSEA JOY DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.135830) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-05 |
Last Update Date | 2022-01-25 |