NPI | 1093119208 |
---|---|
Former Name | KARINA JORDAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62231) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05247) |
Enumeration Date | 2014-10-17 |
Last Update Date | 2023-09-22 |