NPI | 1184104622 |
---|---|
Former Name | ASHLEY MARTELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005510) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-08-15 |
Last Update Date | 2023-03-31 |