NPI | 1023029931 |
---|---|
Other Name | CLEO KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KY PA962) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA962) |
363AM0700X Physician Assistant, Medical (Licence: KY PA962) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2019-01-14 |