NPI | 1033450010 |
---|---|
Former Name | TAYLOR KANE JACOBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: VA 0110007929) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
246ZS0410X Specialist/Technologist, Other Surgical Technologist | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-03-15 |
Last Update Date | 2022-01-19 |