NPI | 1245616291 |
---|---|
Former Name | RUTH SILLS LOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA2037) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2037) |
Enumeration Date | 2015-07-31 |
Last Update Date | 2023-03-28 |