NPI | 1285064154 |
---|---|
Former Name | KELLY BARRIERES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056548) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003160) |
Enumeration Date | 2013-11-13 |
Last Update Date | 2020-04-02 |