| 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 |