NPI | 1033745971 |
---|---|
Former Name | ALYSSA FLETCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0007885) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007776) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-22 |
Last Update Date | 2023-12-18 |