NPI | 1558862490 |
---|---|
Other Name | KAITLYNN NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-51254) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 32003) |
Enumeration Date | 2018-02-26 |
Last Update Date | 2025-10-16 |