NPI | 1275860868 |
---|---|
Former Name | KARLA KANONGATAA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21532) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 7495099-1206) |
Enumeration Date | 2009-11-03 |
Last Update Date | 2022-11-07 |