NPI | 1164830212 |
---|---|
Former Name | KENDRA D PREILIPPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OR PA209206) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60493784) |
Enumeration Date | 2014-07-31 |
Last Update Date | 2022-04-26 |