NPI | 1255870556 |
---|---|
Former Name | COURTNEY MOYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.004996RX) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50.004996RX) |
Enumeration Date | 2017-02-20 |
Last Update Date | 2024-10-21 |