NPI | 1649507757 |
---|---|
Former Name | KARI RENEE TRAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200308) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: LA PA.200308) |
Enumeration Date | 2009-11-10 |
Last Update Date | 2024-04-24 |