NPI | 1669745469 |
---|---|
Former Name | DANIELLE KATHRYN GIPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA164124) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-02-10 |
Last Update Date | 2018-03-17 |