| NPI | 1073040515 |
|---|---|
| Former Name | CANDICE KLEMENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60758102) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-07-19 |