| NPI | 1508125576 |
|---|---|
| Former Name | KELLY NICOLE SHOEMAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 23841) |
| Additional Taxonomies | 2083B0002X Preventive Medicine Obesity Medicine (Licence: MS 23841) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2023-08-22 |