NPI | 1962089961 |
---|---|
Former Name | KAVANYA GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0069107) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0008726) |
208D00000X General Practice (Licence: CO 0069107) | |
Enumeration Date | 2021-03-25 |
Last Update Date | 2022-11-16 |