NPI | 1306819750 |
---|---|
Former Name | TRICIA DAVIDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-00946) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 15-00946) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2021-08-23 |