| NPI | 1497491997 |
|---|---|
| Former Name | HANNAH RAE GLIDEWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS T-05829) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2022041032) |
| Enumeration Date | 2022-05-08 |
| Last Update Date | 2024-07-16 |