| NPI | 1003057951 |
|---|---|
| Former Name | KACY YEVONNE GRIFFIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001167A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: TX PA06217) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2012-05-03 |