NPI | 1558432211 |
---|---|
Former Name | HOLLI LEIGH PAULK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 4072) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2010035678) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2023-04-07 |