NPI | 1326394685 |
---|---|
Former Name | KERRY RAMBO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT 21176) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant (Licence: MT 21176) | |
Enumeration Date | 2012-07-24 |
Last Update Date | 2013-01-18 |