NPI | 1326551136 |
---|---|
Former Name | CRYSTAL M HAMRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2882) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2022-12-01 |