NPI | 1285063347 |
---|---|
Former Name | COURTNEY FERRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7209-23) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2013-11-08 |
Last Update Date | 2023-07-12 |