| NPI | 1164411302 |
|---|---|
| Former Name | COURTNEY COMMELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA923) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA923) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2007-11-02 |