NPI | 1124316021 |
---|---|
Former Name | CHELSEA KAY HAVEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22211) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004055) |
Enumeration Date | 2011-07-13 |
Last Update Date | 2022-12-06 |