NPI | 1649245440 |
---|---|
Former Name | EFFIE BURK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC079) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9102536) |
363A00000X Physician Assistant (Licence: VA 0110007853) | |
Enumeration Date | 2006-02-23 |
Last Update Date | 2023-11-30 |