| NPI | 1548517477 |
|---|---|
| Former Name | CELESTE DAWN GOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01653) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2022-07-20 |