NPI | 1851730022 |
---|---|
Former Name | KRYSTAL SCOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q6185) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10047960) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2016-02-11 |