NPI | 1639133135 |
---|---|
Former Name | CONTESSA DIREAN GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 059893) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238879) |
2083A0300X Preventive Medicine Addiction Medicine (Licence: GA 59893) | |
2083B0002X Preventive Medicine Obesity Medicine (Licence: GA 59893) | |
2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: GA 59893) | |
Enumeration Date | 2006-04-13 |
Last Update Date | 2023-06-09 |