NPI | 1619230588 |
---|---|
Former Name | BRANDI NICOLE FREELON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NE 27989) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 27989) |
207Q00000X Family Medicine (Licence: NE 6691) | |
Enumeration Date | 2012-06-16 |
Last Update Date | 2023-03-01 |