| NPI | 1821485020 |
|---|---|
| Former Name | KIAL LYNNE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60870304) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2022-04-14 |