NPI | 1396365524 |
---|---|
Former Name | EMILY CARROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7506) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-04-17 |
Last Update Date | 2025-10-07 |