NPI | 1366843674 |
---|---|
Former Name | HOLLY RENEE WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1955) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4424) |
363AM0700X Physician Assistant, Medical (Licence: KY PA1955) | |
363AS0400X Physician Assistant, Surgical (Licence: KY PA1955) | |
Enumeration Date | 2014-09-06 |
Last Update Date | 2024-09-13 |