| NPI | 1457443418 |
|---|---|
| Former Name | CHANTELLE BOTKIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 3064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3064) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-10-14 |