NPI | 1528364437 |
---|---|
Former Name | KERI BURLESON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003530) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030945) |
363A00000X Physician Assistant (Licence: MD C05067) | |
363AM0700X Physician Assistant, Medical (Licence: VA 0110003530) | |
Enumeration Date | 2011-02-10 |
Last Update Date | 2022-06-03 |