NPI | 1124393095 |
---|---|
Former Name | MALLORY E HELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01709) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA156716) |
Enumeration Date | 2012-03-12 |
Last Update Date | 2023-10-11 |