NPI | 1053840074 |
---|---|
Former Name | KERIANN WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA031487) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-06-05 |
Last Update Date | 2021-04-19 |