NPI | 1225497118 |
---|---|
Former Name | KAITLYN BROOKE BARGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08256) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC MPA.2498 TL) |
Enumeration Date | 2016-02-19 |
Last Update Date | 2024-09-25 |