NPI | 1245530989 |
---|---|
Former Name | ASHLEY CAROLINE WYATT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 005983) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005983) |
363AS0400X Physician Assistant Surgical (Licence: GA 005983) | |
Enumeration Date | 2010-10-28 |
Last Update Date | 2015-03-11 |