NPI | 1134520406 |
---|---|
Former Name | VALERIE DODD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1948) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA1948) |
363AS0400X Physician Assistant, Surgical (Licence: KY PA1948) | |
Enumeration Date | 2014-09-05 |
Last Update Date | 2020-06-04 |