NPI | 1437308244 |
---|---|
Former Name | BRIDGET L DICKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001919) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1400) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2016-07-15 |