| NPI | 1649561242 |
|---|---|
| Former Name | KELLIE LEIGH FAIRCLOTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0053834) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2024-12-31 |