NPI | 1144489097 |
---|---|
Former Name | CRYSTAL LYNN SNUFFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004099) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
Enumeration Date | 2008-06-05 |
Last Update Date | 2020-03-13 |