| NPI | 1699472068 |
|---|---|
| Former Name | SHELLY ANN LEFFINGWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MO 2023001571) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KS 5381916012) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-07-28 |