NPI | 1588288377 |
---|---|
Former Name | KELLY ELIZABETH MCNAUGHTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA061572) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA005242) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2020-06-08 |
Last Update Date | 2023-08-07 |