NPI | 1124456462 |
---|---|
Former Name | ASHLEY ELIZABETH PHILIPP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA056347) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA056347) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2018-08-20 |