NPI | 1356891782 |
---|---|
Former Name | DAWN DILLMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2148) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC537) |
Enumeration Date | 2016-10-10 |
Last Update Date | 2018-10-29 |