NPI | 1346877206 |
---|---|
Former Name | COURTNEY ANN GLENN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U6531) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-23 |
Last Update Date | 2023-09-06 |