NPI | 1225551427 |
---|---|
Former Name | KELLY DIANE GERKEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61640108) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-07-19 |
Last Update Date | 2025-06-19 |