NPI | 1477995470 |
---|---|
Professional Name | JUSTIN NICOLE KERNODLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1941) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC TL1941) |
Enumeration Date | 2013-07-19 |
Last Update Date | 2024-04-16 |