NPI | 1629368634 |
---|---|
Former Name | CAREY ANNE ENGSTROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2075) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002186) |
363A00000X Physician Assistant (Licence: KY TC357) | |
Enumeration Date | 2011-04-11 |
Last Update Date | 2018-03-17 |