NPI | 1356556195 |
---|---|
Former Name | RACHAEL CAROLEE EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 69299) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N1315) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 526777) | |
Enumeration Date | 2007-05-14 |
Last Update Date | 2021-05-21 |