NPI | 1124189865 |
---|---|
Former Name | DORCAS S OGLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001630A) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: IL 085002858) |
363AS0400X Physician Assistant Surgical (Licence: FL PA9110831) | |
Enumeration Date | 2006-12-13 |
Last Update Date | 2024-03-13 |