| NPI | 1871099002 |
|---|---|
| Former Name | DESTINY DANIELLE SPENCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 55932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY TP282) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 55932) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2022-08-08 |