| NPI | 1710654348 |
|---|---|
| Former Name | CARSON EMMA MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9114474) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA63282) |
| 363A00000X Physician Assistant (Licence: GA 11875) | |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2024-01-23 |