NPI | 1003439373 |
---|---|
Former Name | COURTNEY PAIGE WHIDDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8853) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2020-05-21 |
Last Update Date | 2024-04-16 |