NPI | 1952579997 |
---|---|
Former Name | ERICA KRISTEN BLEVINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 242365) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 51057) |
207R00000X Internal Medicine (Licence: CA A116709) | |
Enumeration Date | 2008-02-12 |
Last Update Date | 2021-12-21 |