NPI | 1083914261 |
---|---|
Former Name | KORTNI R COKELY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7414) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005908) |
Enumeration Date | 2010-10-22 |
Last Update Date | 2024-10-17 |