| NPI | 1306320452 |
|---|---|
| Former Name | COURTNEY MICHELLE WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC 4389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 022607) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2024-07-26 |