| NPI | 1518520238 |
|---|---|
| Former Name | MALLORY BROOKE DOTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011691) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011691) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2021-08-18 |