NPI | 1972251478 |
---|---|
Former Name | KAYLA RYAN HUDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0072798) |
Additional Taxonomies | 171000000X Military Health Care Provider |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-14 |
Last Update Date | 2025-06-17 |