NPI | 1629539325 |
---|---|
Former Name | HOLLY R WHITAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 05275) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-26 |
Last Update Date | 2022-06-17 |