NPI | 1194493635 |
---|---|
Former Name | DEVIN ANTHONY PALMER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61364745) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61364745) |
Enumeration Date | 2021-08-31 |
Last Update Date | 2023-09-29 |