NPI | 1992400899 |
---|---|
Former Name | ALEXIS WAKELEY CHAMBERLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 15030) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2023-04-03 |
Last Update Date | 2023-07-10 |