NPI | 1679010060 |
---|---|
Former Name | COURTNEY LEIGH CASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2702) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60936256) |
Enumeration Date | 2017-01-24 |
Last Update Date | 2024-01-31 |