NPI | 1376133660 |
---|---|
Former Name | CASEY DUNCAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59259) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-01-21 |
Last Update Date | 2021-10-23 |