| NPI | 1518278829 |
|---|---|
| Former Name | CYMANTHIA KEESHA THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 68859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0440473) |
| 261QP2300X Clinic/Center, Primary Care (Licence: MO 207Q00000X) | |
| 207Q00000X Family Medicine (Licence: MO 2013022689) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-02-26 |