NPI | 1689346611 |
---|---|
Former Name | CAITLYN JOAN RISLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4835) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-09-28 |
Last Update Date | 2024-09-12 |