NPI | 1619442977 |
---|---|
Former Name | ABBY BARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-009291) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005734RX) |
Enumeration Date | 2018-10-12 |
Last Update Date | 2024-10-28 |