| NPI | 1295397222 |
|---|---|
| Former Name | CARLEY BROOKE BATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061098) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 023873) |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2024-08-16 |