| NPI | 1760045272 |
|---|---|
| Former Name | SAVANNAH KELLY POOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13123) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112197) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2024-07-08 |