NPI | 1235853987 |
---|---|
Former Name | JOCELYN CAMPO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4648) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-09-27 |
Last Update Date | 2024-02-02 |