| NPI | 1275036121 |
|---|---|
| Former Name | TAYLOR ASHLEY CARLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006121) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 363A00000X) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110006121) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2024-02-12 |