| NPI | 1366978470 |
|---|---|
| Former Name | KINSLEY MARIE COWART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8361) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-03-10 |