| NPI | 1629337324 |
|---|---|
| Former Name | MARYKATHRYN HUDDLESTON COLBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: VA 0101269608) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2024-01-17 |