NPI | 1487918876 |
---|---|
Former Name | EMILY DAWN DURRETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KY PA1728) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1728) |
Enumeration Date | 2012-06-29 |
Last Update Date | 2015-08-28 |