| NPI | 1932894599 |
|---|---|
| Former Name | MALLORY JO ANN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX v8718) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-07-03 |