| NPI | 1376620070 |
|---|---|
| Former Name | KEIA KISHELLE CLAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-105930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-01397) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-05-24 |