NPI | 1336557883 |
---|---|
Former Name | ASHLEY NICOLE COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA1907) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1907) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2015-09-18 |