NPI | 1144885013 |
---|---|
Former Name | DEVON LEE PERKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002950A) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MS PA00575) |
Enumeration Date | 2019-05-07 |
Last Update Date | 2022-07-25 |