NPI | 1760461875 |
---|---|
Former Name | KELLY JEAN MORGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.14004R) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 14004R) |
207R00000X Internal Medicine (Licence: WA MD60821843) | |
Enumeration Date | 2006-01-17 |
Last Update Date | 2023-10-23 |