NPI | 1790281053 |
---|---|
Former Name | LEANDRA CONLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A17756) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 17756) |
Enumeration Date | 2018-04-04 |
Last Update Date | 2021-09-29 |