| NPI | 1396933867 |
|---|---|
| Former Name | CARRLENE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3687) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3687) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2020-09-03 |