NPI | 1538544242 |
---|---|
Former Name | PAIGE M CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005028) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110005028) |
363AM0700X Physician Assistant, Medical (Licence: VA 0110005028) | |
Enumeration Date | 2015-07-23 |
Last Update Date | 2020-09-12 |