NPI | 1093420614 |
---|---|
Former Name | ABBY SALMONSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN PA5390) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5390) |
Enumeration Date | 2023-01-18 |
Last Update Date | 2024-09-22 |