| NPI | 1710210570 |
|---|---|
| Former Name | COURTNEY JAYNE ROLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OH 50.002960) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.002960) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2022-01-25 |