NPI | 1093340515 |
---|---|
Other Name | KYLIE NICOLE FARWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA201995) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-03-04 |
Last Update Date | 2020-10-08 |