NPI | 1609364785 |
---|---|
Former Name | KELSEY ELISABETH GRIFFITTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006122) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3586) |
Enumeration Date | 2018-04-25 |
Last Update Date | 2021-10-31 |