NPI | 1033415203 |
---|---|
Former Name | KENDYL BRYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-426) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AR PA-426) |
363AS0400X Physician Assistant, Surgical (Licence: AR PA-426) | |
Enumeration Date | 2011-02-04 |
Last Update Date | 2018-10-19 |