NPI | 1730799859 |
---|---|
Former Name | COURTNEY CARMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-02560) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-08-04 |
Last Update Date | 2023-03-03 |