| NPI | 1912142829 |
|---|---|
| Former Name | KATRINA MICHELLE HERVEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2021-0057) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD29388) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2021-11-15 |