NPI | 1275913808 |
---|---|
Former Name | ELENA SWICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3410) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC141) |
Enumeration Date | 2015-06-09 |
Last Update Date | 2025-02-11 |