NPI | 1447391271 |
---|---|
Former Name | FONDA KAY BARTGES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: FL PA9104425) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010136-1) |
363A00000X Physician Assistant (Licence: FL PA9104425) | |
Enumeration Date | 2007-02-12 |
Last Update Date | 2015-03-23 |