NPI | 1659889228 |
---|---|
Former Name | KIRBY HOLLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006023) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110006023) |
Enumeration Date | 2018-01-17 |
Last Update Date | 2023-06-30 |