NPI | 1609115161 |
---|---|
Former Name | ASHLEY NICOLE KERAMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060760) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VA 0110-004144) |
Enumeration Date | 2013-02-04 |
Last Update Date | 2023-03-27 |