NPI | 1093476111 |
---|---|
Former Name | JORDANNA DOMINIQUE BADDELEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 60816) |
Enumeration Date | 2022-01-02 |
Last Update Date | 2022-10-26 |