NPI | 1659829364 |
---|---|
Former Name | AMBER BISHOP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3885 - 23) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2016-09-12 |
Last Update Date | 2021-01-15 |