NPI | 1235597956 |
---|---|
Former Name | ASHLEY R JACOB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006030) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10001903A) |
Enumeration Date | 2016-02-09 |
Last Update Date | 2022-12-15 |