NPI | 1720511587 |
---|---|
Former Name | KAELA SIMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 0516053) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-09 |
Last Update Date | 2020-04-28 |