NPI | 1619352259 |
---|---|
Former Name | JORDAN PARROTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006088RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC393) |
Enumeration Date | 2015-07-24 |
Last Update Date | 2021-04-16 |