| NPI | 1548414931 |
|---|---|
| Former Name | LACREASIA KORSHANNA WHEAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD61387943) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA 43571) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2023-10-19 |