NPI | 1184905754 |
---|---|
Former Name | COURTNEY JANE SMITH MEYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118264) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03081) |
363AM0700X Physician Assistant, Medical (Licence: NC 0010-03081) | |
Enumeration Date | 2011-09-08 |
Last Update Date | 2024-04-18 |