| NPI | 1114476611 |
|---|---|
| Former Name | KARISSA CARPENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002164A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115876) |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2025-05-15 |