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 |