NPI | 1649727306 |
---|---|
Former Name | CAITLIN MEREDITH DEBOEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06516) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00405600) |
Enumeration Date | 2016-09-09 |
Last Update Date | 2021-08-24 |