| NPI | 1548789936 |
|---|---|
| Former Name | COURTNEY HABART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-112159) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10002291A) |
| Enumeration Date | 2017-09-17 |
| Last Update Date | 2024-02-19 |