NPI | 1730374794 |
---|---|
Former Name | KARA RENEE TRAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA1064) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA1064) |
Enumeration Date | 2007-09-12 |
Last Update Date | 2020-12-06 |