NPI | 1730558461 |
---|---|
Former Name | MASON CASTLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.1306) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2422) |
Enumeration Date | 2015-09-23 |
Last Update Date | 2018-07-19 |