NPI | 1629637327 |
---|---|
Former Name | ASHLEY LYNN MARNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7126) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-06-07 |
Last Update Date | 2022-05-05 |