| NPI | 1326651803 |
|---|---|
| Former Name | JANELL ANN COUPERTHWAITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |