NPI | 1184922544 |
---|---|
Former Name | CAITLIN ANN CLARY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5298) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR MD152931) |
Enumeration Date | 2011-03-09 |
Last Update Date | 2020-09-09 |