NPI | 1306407010 |
---|---|
Former Name | ABBEY CROSSMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4721) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007171) |
363AM0700X Physician Assistant, Medical (Licence: WI 472123) | |
Enumeration Date | 2019-06-24 |
Last Update Date | 2024-07-23 |