NPI | 1437311354 |
---|---|
Former Name | CANDICE ELIZABETH ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-36466) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407020) |
Enumeration Date | 2008-07-01 |
Last Update Date | 2019-04-23 |